diabetes Hepatocellular Carcinoma

[jsdwd]

After a long stint with Cirrhosis (Alcoholic), I have been diagnosed with Primary Hepatocellular Carcinoma (HCC). Detection was through a regular screen and is quite early.

I have four questions.

1. Does anyone have familiarity with this problem and know of veterans or non-veterans support groups that can help me navigate the whole business of treatment, transplants, etc.? This group was invaluable when I was working with the VA to get disability benefits and I'm wondering if there isn't something like this for my current situation...

2. I am currently 100% disabled via TDIU with an underlying rating of 80% due to PTSD with alcoholism (in remission), Depression and Anxiety, Diabetes II (Agent Orange presumptive), and a few other more minor problems (e.g. hearing loss). Does it make sense for me to file a claim to add the HCC to the list and perhaps move 100% on basic rating? Are there some benefits I would get that I'm not currently getting? (Including survivor benefits)

3. I know the VA healthcare system does do transplants. Does anyone have familiarity with this process? What transplant criteria do they use?

4. Is anyone aware of any research studies or clinical trials underway that look at the effect of Agent Orange on the onset of liver cancer?

I'm just looking for information and anything would be helpful.

Thanks

[jvretiredvet]

Wow.

2. I am currently 100% disabled via TDIU with an underlying rating of 80% due to PTSD with alcoholism (in remission), Depression and Anxiety, Diabetes II (Agent Orange presumptive), and a few other more minor problems (e.g. hearing loss). Does it make sense for me to file a claim to add the HCC to the list and perhaps move 100% on basic rating? Are there some benefits I would get that I'm not currently getting? (Including survivor benefits)

First, had you ever attempted to service connect the liver cirrhosis ? What was the result ?

While it might be totally obvious to you, do you have evidence or a medical opinion stating that the EtOH abuse is/was caused by your mental disorder? You need to have this.

Again while it might be totally obvious to you, do you have a medical opinion or evidence in your records that the CA is/was caused by or a result of the cirrhosis? You need to have this as well.

WRT any additional financial benefits to be had if the HCC becomes service connected .... well, yes.

If service connected, during the duration when you have the active cancer, you are eligible for a single 100% based on Diagnostic Code (DC) 7343 at 38 CFR 4.114 http://www.benefits....ART4/S4_114.DOC . This single 100% plus your other disabilities should qualify you for Special Monthly Compensation-s (SMC-s) at 38 CFR 3.350(i)(1) http://www.benefits....0.DOC . Note: you will keep the SMC-k as well.

When you have the liver transplant, you will be evaluated under DC 7351. A 100% evaluation is warranted for <at least> a year post-surgery. You will still qualify for SMC-s and SMC-k.

WRT survivor's benefits ... Bluntly speaking, you are far more likely to pass from either the HCC or the sequelae of the transplant than anything else. A service connected death is "better" than your dependents qualifying for DIC because of the total-disability-for-10-year rule because there is a <somewhat> greater death benefit.

Again, wow.

After a long stint with Cirrhosis (Alcoholic), I have been diagnosed with Primary Hepatocellular Carcinoma (HCC). Detection was through a regular screen and is quite early.

I have four questions.

1. Does anyone have familiarity with this problem and know of veterans or non-veterans support groups that can help me navigate the whole business of treatment, transplants, etc.? This group was invaluable when I was working with the VA to get disability benefits and I'm wondering if there isn't something like this for my current situation...

2. I am currently 100% disabled via TDIU with an underlying rating of 80% due to PTSD with alcoholism (in remission), Depression and Anxiety, Diabetes II (Agent Orange presumptive), and a few other more minor problems (e.g. hearing loss). Does it make sense for me to file a claim to add the HCC to the list and perhaps move 100% on basic rating? Are there some benefits I would get that I'm not currently getting? (Including survivor benefits)

3. I know the VA healthcare system does do transplants. Does anyone have familiarity with this process? What transplant criteria do they use?

4. Is anyone aware of any research studies or clinical trials underway that look at the effect of Agent Orange on the onset of liver cancer?

I'm just looking for information and anything would be helpful.

Thanks

[jsdwd]

Thanks for your response.

I have not applied for service-connected Cirrhosis. There didn't seem to be any point as I was at 100% with the TDIU.

I do have a letter that ties my alcoholism to PTSD. Moreover, my rating letter cites "Service connection for post traumatic stress disorder with secondary depression,

anxiety, and alcohol dependence" The Cirrhosis has been diagnosed as Alcoholic Cirrhosis, so I think the chain is there.

I do not have a letter that ties the CA to the Cirrhosis, but can get one fairly easily, I think.

Thanks for the info on benefits, I will follow up. At this stage, the CA is treatable with Trans-catheter Arterial Chemo-embolization which is a localized chemo that should kill or shrink the relatively small lesions that I have. The plan is that this treatment will be a 'bridge to transplant'.

Thanks again for your help.

[jvretiredvet]

Sorry about the delayed response ... the warden only allows me a certain amount of internet time.

Anyway, I understand. However, it is sometime better (whatever better means to you) to get sumpin' service connected (whether on a direct service connection or perhaps a secondary basis) "just in case", even if there will be no immediate increase in financial benefits. Yes, you might go through some administrative agony with no immediate benefit, but the S/C would have been established.

And, in your situation, you might have qualified for a scheduler 100% if a separate evaluation for cirrhosis was added (if that is what you're seeking). Again, no immediate benefit, but ...

Well, good luck with chemo.

After a long stint with Cirrhosis (Alcoholic), I have been diagnosed with Primary Hepatocellular Carcinoma (HCC). Detection was through a regular screen and is quite early.

I have four questions.

1. Does anyone have familiarity with this problem and know of veterans or non-veterans support groups that can help me navigate the whole business of treatment, transplants, etc.? This group was invaluable when I was working with the VA to get disability benefits and I'm wondering if there isn't something like this for my current situation...

2. I am currently 100% disabled via TDIU with an underlying rating of 80% due to PTSD with alcoholism (in remission), Depression and Anxiety, Diabetes II (Agent Orange presumptive), and a few other more minor problems (e.g. hearing loss). Does it make sense for me to file a claim to add the HCC to the list and perhaps move 100% on basic rating? Are there some benefits I would get that I'm not currently getting? (Including survivor benefits)

3. I know the VA healthcare system does do transplants. Does anyone have familiarity with this process? What transplant criteria do they use?

4. Is anyone aware of any research studies or clinical trials underway that look at the effect of Agent Orange on the onset of liver cancer?

I'm just looking for information and anything would be helpful.

Thanks